VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 0968149
Sex: F
Age: 35
State:

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: myalgias, sore throat, congestion, cough x24 hours; ibuprofen and tylenol for symptomatic relief; resolved

Other Meds: lamictal, adderall, ibuprofen

Current Illness: none

ID: 0968150
Sex: F
Age: 50
State: OH

Vax Date: 01/14/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Mildly pruritic eruthematous patch just inferior to injection site

Other Meds: Fish oil, cholecalciferol

Current Illness: None

ID: 0968151
Sex: F
Age: 71
State: TX

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: pencillian

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Arm shot site stays red, heats up, itches

Other Meds: none

Current Illness: none

ID: 0968152
Sex: F
Age: 57
State: IL

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Balsam of Peru, Methyl Methacrylate, Toluene Sulfonamide Formaldehyde Resin, Contrast Die (Ominpaquez), Thimerosal; Suspected due to skin test borderline results: Allergies Budesonide, Chloroxylenol, Cobalt Dichloride, Cocamidopropyl Betaine, Dibucaine, Lauryl Glucoside, Lidocaine, Propolis, Tea Tree Oil, Triamcinolone Acetonide

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Besides the usual feeling of lazy, tired, feeling like I need to refresh, chills, body achiness. My lymph nodes in the arm pit burned ached, diarrhea. At 4:30 my lower lip itched swelled briefly, then left. I slept a lot. Wed (day 2) Chills, diarrhea, sweaty. Red raised injection site still, ache burning. Body aches. Thur diarrhea. Slept 11 hrs. Fri -normal.

Other Meds: multi vitamin, famotidine 10mg, estrogen progestrone

Current Illness: None

ID: 0968153
Sex: F
Age: 43
State: MN

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine, percoset

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient felt like a belt was tight around her chest from 40 minutes after vaccine and symptoms lasted for 4 hours. Patient did not feel short of breath or pain, just chest tightness to the point of irritation

Other Meds: Medroxyprogesterone, vit c, vit d, zinc

Current Illness: None

ID: 0968155
Sex: F
Age: 40
State: KS

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: The day after the injection, I had the normal reaction (headache, fatigue, nauseous, etc). Back to normal the following day. Six days after the vaccine -- the area around the injection site became very itchy and red. On day 7 and 8 there was tenderness, swelling, red and itchy. I took Advil on day 7 and 8. Day 9....symptoms have improved dramatically.

Other Meds: Junel 1/20 Multivitamin Vital Proteins collagen

Current Illness: no

ID: 0968156
Sex: F
Age: 40
State: MI

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: toradol tide bleach norco asprin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Tingling numbness on my left side due to the vaccine painful

Other Meds: None

Current Illness: None

ID: 0968157
Sex: F
Age: 63
State: NY

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: ampicillin, erythromycin, Levaquin Sulfites, shrimp, mangoes, cherries, eggplant, Latex sensitive

Symptom List: Pharyngeal swelling

Symptoms: Throat and back of tongue swelling, hot flushes in head and face. High blood pressure and pulse.

Other Meds: Topical Estrace Ointment, Vitamin D, Magnesium, Hyaluronic Acid, Viviscal, Topical Rogaine

Current Illness: None

ID: 0968158
Sex: F
Age: 31
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Macrobid

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Angioedema, lower lip swelling, lightheadedness, throat tightness, tingling lips, tongue, throat and difficulty swallowing.

Other Meds: Unknown

Current Illness: PTSD

ID: 0968159
Sex: M
Age: 68
State: FL

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: swelling and redness under right eye

Other Meds: Metformin

Current Illness:

ID: 0968160
Sex: F
Age:
State: MA

Vax Date:
Onset Date:
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Reglan, compasine and biaxin.

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Headache, fever, chills, nausea, vomiting, muscle aches, fatigue

Other Meds: Prilosec, pro air, singular, valtrex, vitamin D, vitamin B complex, emergency vitamin C drink

Current Illness: Covid 19

ID: 0968161
Sex: F
Age: 57
State: NY

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: sulfa, penicillin

Symptom List: Rash, Urticaria

Symptoms: COVID?19 Vaccine EUA, arm swelling, hard, felt very warm, red around injection sight from 1/15 thru 1/17; 1/18 black and blue through 1/23, during this time any time taking a shower, area would burn when hot water hit area; 1/23 black and blue and rough to the touch, almost like a sunburn and area looks like it will peel

Other Meds: flonase, antibiotic, centrum

Current Illness: potential sinus infection which is why I was on antibiotics

ID: 0968162
Sex: F
Age: 41
State: NJ

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Gluten, eggs, dairy, soy, adhesives, oral antibiotics

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Day 1-2: common side effects- sore arm and fatigue Day 3 (1/10)- itchy throat began. And and cough started with it around 1/12. Due to my allergy history, we determined the best solution was to double up on antihistamines for a day or two. This reduced the itchy/sore throat but cough remained until 1/20). *a covid test was given 1/18 and results were negative.

Other Meds: Levothyroxine, Nuvaring, Xyzel

Current Illness: None

ID: 0968163
Sex: M
Age: 58
State: GA

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Have had minor reaction to shrimp

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Noticed rash in area of injection one week after vaccination. Rash was about 3 inches by 4 inches. It stayed solid for about 36 hours and then went away leaving a circle of the rash at the outer most area . Slight rash is still visible 2 days following first noticing it.

Other Meds: Lisinopril-HCTZ Atorvastatin

Current Illness: None

ID: 0968164
Sex: M
Age: 29
State: WA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Primaquine

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Uncontrollable shivers for about 20 min, with muscle spasms, and the tempature of 92?F lasting for about 30-45min.

Other Meds: Acetaminophen

Current Illness: None

ID: 0968165
Sex: M
Age: 87
State: CA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: - vomiting multiple times 2-3 hours after the vaccine - severe headache 2-3 hours after the vaccine- given tylenol - severe dizziness 2-3 hours after the vaccine - fainting 2-3 hours after the vaccine - extremely tired

Other Meds: advil

Current Illness: none

ID: 0968166
Sex: F
Age: 54
State: PA

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/23/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Arm was a little sore at injection site on 12/30/20, day of injection. Woke up 12/31/20 and had a nickel-sized lump/redness. Lump lasted about 2 days then disappeared on 1/3/21. On 1/7/21 axilla was tender and occasionally painful, On 1/8/21 lump and tenderness returned to injection site at 1:00pm. At 6:30pm that day site had a 50 cent piece lump which was red, raised and warm. Took Benadryl. Area was slightly more red and tender am of 1/9/21. so called MD and antibiotic ordered. Arm is slowly improving each day. Axilla is still painful. Had a similar reaction to Tdap 20 years ago which was treated as cellulitis. No known hx. of COVID, but had classic COVID symptoms in December when she tested negative.

Other Meds:

Current Illness:

ID: 0968167
Sex: F
Age: 51
State: WA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Low potassium

Other Meds:

Current Illness:

ID: 0968168
Sex: M
Age: 69
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I am caregiving for my 69 year old who need Covid 19 vaccination.

Other Meds:

Current Illness:

ID: 0968169
Sex: F
Age: 32
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: None

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Fatigue Fevers and Chills started day 1 and recovered day 3 Headache started day 3 and is ongoing (today is day 3 after vaccine)

Other Meds: None

Current Illness: None

ID: 0968170
Sex: F
Age: 61
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, avelox, latex, defoliant, botox, MSG, aspartame

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Migraine with extremely bright and larger than usual scintillating photoscotoma visual Aura. Headache, stuffy nose, light sensitivity, sound sensitivity, duration approx 3 hours, treated with ibuprofen. Had chills 2 times each day for 2 days following.

Other Meds: Armour thyroid 30 mg daily, escitalopram 10 mg daily, zyrtec 10 mg daily, vitamin d3k2 daily

Current Illness: None

ID: 0968171
Sex: F
Age: 26
State: NY

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: adverse reaction history to lidocaine seasonal allergies, allergy to cats

Symptom List: Unevaluable event

Symptoms: One week after vaccination, a red itchy rash developed on the same arm. Rash faded overnight and was totally gone after three days. 200 mg of ibuprofen taken on day one; all other meds taken during this timeframe were my normal daily meds.

Other Meds: paroxetine 40 mg QD montelukast 10mg QD cetirizine 10mg QD junel fe 1.5/30 QD

Current Illness:

ID: 0968172
Sex: F
Age: 44
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Environmental allergies- many outdoor plants, cats, horses, birds

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Racing heart, dizzy, flushed face, headache

Other Meds: None

Current Illness: none

ID: 0968173
Sex: F
Age: 44
State:

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

Symptom List: Injection site pain, Pain

Symptoms: Hives on face/chin, self-limited, resolved without treatment

Other Meds: NA

Current Illness: None

ID: 0968174
Sex: M
Age: 83
State: MN

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: These symptoms lasted 3-4 days: Extreme sleepiness; inability to open eyes; tremors; delusions/hallucinations; non-ambulatory; required assistance to sit, in and out of bed, in and out of chair, in and out of bathroom; tremors; anorexia; difficulty swallowing; slurred/difficult speech; hypotension; aches on right side hip, waist, leg, back; Required 24-hour supervision/caregiving. Marked improvement on Day 5; by Day 6, at 80% improvement. FOR ITEM 20 BELOW, we are indicating "unknown" as the patient is still not 100%. FOR ITEM 21 BELOW, we had a conference call with the primary physician, but not an in-person office visit.

Other Meds: Warfarin, Simvastatin, Memantine, Donepezil, Centrum multi vitamin, Vitamin D3, Alendronste Sodium, Glycophyrrolate, Amoxicillin, Mirtazapine.

Current Illness: Cognitive impairment, progressive neurological decline, chronic insomnia

ID: 0968175
Sex: F
Age: 34
State: VA

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Right upper arm pain/redness/swelling - golf ball sized starting 1/23/2021. Mild itching at onset, now resolved. No other sx.

Other Meds:

Current Illness:

ID: 0968176
Sex: F
Age: 58
State: AZ

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Continuous tinnitus started the day after my second vaccine administration. No treatment taken. Has not gone away.

Other Meds: levothyroxine, wellbutrin

Current Illness: exposed to covid patient 1/9/21- low risk. I developed a mild cough which I had when I got my second vaccine. My first vaccine was on 12/23/2020. I did not have any tinnitus after my first vaccine.

ID: 0968177
Sex: F
Age: 23
State: WA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Azithromycin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Headache, muscle ache, fatigue, soreness at injection site

Other Meds: Venlafaxine and birth control pill

Current Illness: None

ID: 0968178
Sex: F
Age: 43
State: IN

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Cold chills, body ache, headache, malaise

Other Meds: None

Current Illness: None

ID: 0968179
Sex: F
Age: 37
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin

Symptom List: Nausea

Symptoms: Chills, low grade fever 99.7, headache, tiredness, nausea started 10 1/2 hrs after second dose vaccine. Fever and chills lasted for 6 hours. Ibuprofen 600mg taken for headache twice. Headache, tiredness , nausea and feeling crappy remains. 19 hours after vaccine. If symptoms worsen or do not improve after 48 hours, I will contact my PCP. I believe I have 2 swollen lymph nodes just above my left collar bone. I had one swollen before I received 2nd vaccine.

Other Meds: None

Current Illness: None

ID: 0968180
Sex: F
Age: 41
State: OH

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Neosporin

Symptom List: Injection site pain

Symptoms: Injection arm was very sore for first 3 days, but felt better and only bothered me to touch injection site. Starting day 8, I noticed my arm was itchy and more tender and hot to touch. Looked in the mirror and have a red splotch that I didn?t have before today.

Other Meds: Escilitopram- daily Iron-daily Vitamin C-daily Biotin- daily Collagen- daily L-glutamine daily Fiber- daily Lions Mane- daily Alazopram- 2-3 x/week as needed

Current Illness: None

ID: 0968181
Sex: F
Age: 70
State: RI

Vax Date: 01/16/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Cipro, Dilantin, Contrast dye.

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Developed hives on January 21, 2021. They resolved on January 22, 2021.

Other Meds: Hydroxichloroquine 200 mg qd, Vitamin B12 IM 1000mcg q3 wks, Calcium 700 mg qd, Vitamin D3, 2000 IU qd.

Current Illness: Asthma, arthritis, 1 functioning kidney.

ID: 0968182
Sex: F
Age: 20
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Pain at injection site

Other Meds:

Current Illness:

ID: 0968183
Sex: M
Age: 58
State: GA

Vax Date: 01/15/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Have had slight reaction to shrimp

Symptom List: Tremor

Symptoms: Rash appeared in injection area about a week after vaccination. Rash is about 3 inches by 4 inches. Rash remained for over a day. It is slowing clearing away but leaving a rash ring in the outer area of affected area.

Other Meds: Lisinopril; HCTZ; Atorvastatin

Current Illness: No

ID: 0968184
Sex: F
Age: 44
State: NY

Vax Date: 12/23/2020
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: First Dose December 23,2020 1pm, Second dose January 13, 2021 6pm

Other Meds: LOTREL and benazepril, Montelukast

Current Illness: none

ID: 0968185
Sex: F
Age: 52
State: CA

Vax Date: 01/02/2021
Onset Date: 01/09/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: Motrin

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: 1 week after the shot, I felt pain and itching at the site. It was hard and swollen with redness around it. Improved some with an antihistamine. On the next day, it was more red and painful. The day before I was working in the yard and thought I may have got it infected. I did call my health care physician, and was prescribed clindamycin. It got better then worse so I did seek care on the 5th day but did not take the recommended prednisone and then improved much after 6 days.

Other Meds: levothyroxine

Current Illness:

ID: 0968186
Sex: F
Age: 50
State: CA

Vax Date: 01/03/2021
Onset Date: 01/03/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa Sumitripan Shellfish

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Within 20-30mins I have metallic taste, headache, left arm heavy & numb and tingling 2fingers, BP 177/104 . I was observed for 1hr 10mins. On my way home my face was tingling. I called advice nurse and doctor talk to me. Tylenol for at least 2 days 1000mg and benadryl 50mg or 25mg . 3 days after I eat pineapple I felt I was chocking, hacking cough, wheezing and throat burning. Never had an allergy with pineapple , Called and talk to a doctor. Benadryl 50mg q6hrs x2 and prednisone 20mg with relief.

Other Meds: Labetalol tabs Hydralazine tabs Tylenol 1000mg tabs Benadryl 35mg tabs

Current Illness: Allergy rhinitis Seasonal allergies Asthma Migraine

ID: 0968187
Sex: F
Age: 37
State: OH

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Azithromycin, lemongrass, grapefruit, vinegar

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: One week after vaccination the injection site became extremely red, itchy, swollen, hard, and warm to the touch, expanding to roughly 4 inches in diameter. There was bubbling under the skin at injection site. Pain radiated to the underarm and lymph node of left arm. Hydrocortisone cream did not help. Mupirocin ointment, Benadryl cream, and oral antihistamines (Benadryl and Zyrtec) for the following 3 days helped clear much of the redness, itch, and warmth, Some redness, swelling, and minor bubbling are still present.

Other Meds: Adderall 30mg, Cymbalta 60mg, Xanax 0.25mg, Feosol Complete, Motrin

Current Illness:

ID: 0968188
Sex: M
Age: 25
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Ibuprofen

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Chills

Other Meds: Synthroid, pantoprazole, citalipram

Current Illness: Common cold

ID: 0968189
Sex: F
Age: 43
State: NY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Severe nerve pain in left arm. Hand and fingers kept going numb. High fever 103. Aches and pains all throughout body.

Other Meds: Birth control and Zyrtec

Current Illness:

ID: 0968190
Sex: F
Age: 23
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Anaphylactic reaction: tongue/throat numbness, throat closure, rapid heart rate, dizziness, body tremors.

Other Meds:

Current Illness:

ID: 0968191
Sex: F
Age: 32
State: CA

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: multiple allergies and sensitivities

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Patient received Moderna vaccination at approximately 10:30 and reported to observation. Patient reported multiple sensitivities and allergic reactions at screening and was recommended for 30 minute observation. 10:55 patient reported feeling nauseous and requested water. Provided water and recommended patient remove large coat. 11:05 patient reported having an itchy feeling in her throat. No shortness of breath, wheezing, respiratory distress. BP 148/104, 62. patient instructed on Benadryl actions, side effects. Administered 50mg Benadryl IM to right deltoid. After 15 minutes patient reports itchy feeling resolved and she feels better. Recommended patient call for ride given sedating effects of Benadryl. BP 128/80 68. Patient states she feels better, declined need for ride home and left observation.

Other Meds:

Current Illness:

ID: 0968192
Sex: F
Age: 61
State: OR

Vax Date: 01/15/2021
Onset Date: 01/19/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: enlarged clavicle lymph node

Other Meds: Linisonpril/HCTZ 25/12.5, Multi Vits, Vit D, red rice yeast tab, apap and ibuprofen

Current Illness: URI 1-6-2021

ID: 0968193
Sex: F
Age: 37
State: WI

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Wellbutrin, Amoxicillin, prednisone

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Dizziness and sleepiness starting at 10 minutes post injection, lasting 2 hours

Other Meds: Lamictal, Trazodone, Celexa, Singulair, Zyrtec, Prenatal vitamin, folic acid, low dose aspirin

Current Illness: None

ID: 0968194
Sex: F
Age: 47
State: PA

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Patient received the vaccine 12/28/20. She developed a localized reaction of redness, warmth, and swelling on 1/5/21. She went to ER due to chills later in the day and was diagnosed with COVID. She was given antibiotics for arm, but reaction was gone the next day so she never filled Rx.

Other Meds:

Current Illness:

Date Died: 01/13/2021

ID: 0968195
Sex: M
Age: 82
State: FL

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None known.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: My dad got the Moderna Vaccine on Tuesday, January 12, 2021 in his left arm at the Mall injection site for the Health Department. He was told that the side effects could mean his arm hurting, tiredness, headache, and even a low grade fever. Additionally, the site informed us both (as I was with him to get the injection) that this was all normal and not to seek medical attention unless these symptoms last longer than 72 hours. That evening, my dad was experiencing all of those symptoms, and went to bed at 7pm. A little after 10am on Wednesday, January 13, 2021, when he awoke, my dad went to the bathroom vomiting. This was where he collapsed and went into cardiac arrest. Fire/Rescue was dispatched about 10:30am after my mom started CPR. County Fire Rescue EMTs and Paramedics continued CPR and other attempts at reviving him all the way to Hospital Emergency Department. He was pronounced dead at 12:14pm on Wednesday, January 13, 2021. We have no doubt my dad, following the instructions of the injection facility, thought he was just experiencing the side effects of the vaccine. He had no chance. Had this injection been done in the RIGHT arm, perhaps he could have recognized the arm numbness being that of an impending heart attack. We really miss Dad. He served this country with distinction for over 50 years, and we believe his country failed him.

Other Meds: I do not have that information at the time of this filing. I?m his Son making the filing

Current Illness: None known

ID: 0968196
Sex: F
Age: 44
State: AR

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Fever Incredible body aches Headache Sore throat Arm tenderness where I got the shot

Other Meds: Synthesis 125 mcg Nexium 40 mg Wellbutrin 300 mg Zoloft 100 mg Fenofibrate 40 mg Lasix 20 mg Phenergan 25 mg as needed Today I took DayQuil to try and help with symptoms

Current Illness: I was diagnosed with Covid-19 12/13/2020

ID: 0968197
Sex: F
Age: 52
State: PA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Dizziness, enlarged lymph nodes from axilla to mandible on same side as shot. Body aches, chills, headache.

Other Meds:

Current Illness:

ID: 0968198
Sex: F
Age: 34
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: I experienced high fever of 101.7, body and muscle pain, headaches, feeling tired for a full day, the day after receiving the vaccine. On the second day after the vaccine I experienced headaches and mild body aches that resolved with over the counter medication.

Other Meds: Levothyroxine

Current Illness: None

ID: 0968199
Sex: M
Age: 21
State: MI

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: high fever (102.3), muscle aches, local injection site reaction, head ache and shortness of breath and chest discomfort

Other Meds: Singulair Oral. PriLOSEC Oral. Inhalers. --14:26

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm